Durbin Questions Witnesses In Senate Judiciary Committee Hearing On Pharmacy Benefit Managers
Today’s hearing investigated the role PBMs play in the drug supply chain and their impact on competition, patients, providers, & pharmacies
WASHINGTON – U.S. Senate Democratic Whip Dick Durbin (D-IL), Ranking Member of the Senate Judiciary Committee, today questioned witnesses during a Senate Judiciary Committee hearing entitled “PBM Power Play: Examining Competition Issues in the Prescription Drug Supply Chain.” The hearing investigated the role pharmacy benefit managers (PBMs) play in the drug supply chain and their impact on competition, patients, providers, and pharmacies.
Durbin began by challenging his colleagues on both sides of the aisle to come together to find bipartisan solutions to the problem of PBMs distorting patient affordability and choice in the prescription drug market.
“I suspect that our witnesses have given us a challenge as to whether we are going to do something about it [PBMs]. I suspect there is a possibility that we may even have to legislate, pass a bill, make a law. And I think you have spelled out in graphic terms why this is essential,” Durbin said. “My challenge to colleagues on my side of the aisle and the other side of the aisle is: let’s not walk away from this hearing and say, ‘oh my god, that’s really a mess.’ Let’s do something that we were elected to do and legislate. The Chairman has some legislation—I’m cosponsoring some of it with him. Each of us has an idea, I’m sure, because we wouldn’t have run for office if we didn’t. And we have the challenge that’s given to us by this panel.”
Durbin then asked Dr. Sheetal Kircher, Associate Professor at Northwestern University’s Feinberg School of Medicine and a gastrointestinal oncologist at Northwestern Medicine, about the real-world impacts that PBMs have on her practice.
“I try to imagine, you’re walking into that patient room day after day after day and explaining that the therapy he [the patient] needed to stop the cancer in his body was being held up because of a fight, a jurisdictional fight, about how to get the drug to the hospital,” Durbin said. “How in the world do you possibly explain that to your patient?”
Dr. Kircher explained that as an oncologist, she is very well trained to deliver bad news. “But what I’ve noticed since I started practicing in 2011 is increasing conversations that I am not prepared for. It’s interesting that I can have a conversation about end-of-life, but I’m having more and more about affording our medications and making these difficult decisions that are well beyond the four walls of our clinic and involve just obtaining the medications. So as fast as we are hustling in the clinic to see patients and get them what they need, we hit this roadblock that is really difficult to deal with,” Dr. Kircher said.
Durbin then asked his colleagues, “What if this was a member of your family? What if it was your spouse or your child that we are talking about? That really brings it home. Dr. McDonough, what you and Dr. Kircher have told us about your belief in your professional responsibilities to the patient really rings true to me. You care. And because you care, that patient is going to get better treatment. And the bottom line, Professor Sood, is you’ve gone through and analyzed this from an economics viewpoint. I’m really impressed with what you found.”
Durbin continued, “Mr. Scott, the bottom line is this. You argue that PBMs give us competition, choice, and flexibility and the evidence is absolutely to the contrary. What you just heard, the illustrations [from the witnesses] on both sides of you, are proof positive that is not your goal. I could go into vertical integration, the opioid crisis, spell out what PBMs have done over and over again, but how in the hell do you answer Dr. Kircher’s plea to us to give her patient the medicine he needs to get well, and get into a battle over pricing? You say you pick a PBM voluntarily. Clearly that’s not exactly the case. Voluntarily she had a pharmacy in her hospital that she wanted to use. But you didn’t give her that choice. I don’t see how PBMs, in the examples that we have heard today, have done the right thing for the patient. They’ve done the right thing for their bottom line.”
Durbin concluded, “If this isn’t a call to action, I don’t know what is. Imagine a member of your own family that you love going through this mess because we failed to change the law. I hope we do.”
Along with Dr. Kircher, today’s hearing also featured Randy McDonough, PharmD and Owner of Towncrest Pharmacy; Neeraj Sood, PhD, Interim Chair and Professor of the Department of Health Policy and Management at the University of Southern California; and JC Scott, President and CEO of the Pharmaceutical Care Management Association (PCMA).
Video of Durbin’s questions in Committee is available here.
Audio of Durbin’s questions in Committee is available here.
Footage of Durbin’s questions in Committee is available here for TV Stations.
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